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Sleep apnoea is a risk factor for acute kidney injury after coronary artery bypass grafting

Jieli Kua1, Liang-Ping Zhao1, Theodoros Kofidis2

  • 1Department of Cardiology, National University Heart Centre Singapore, Singapore.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|November 20, 2015
PubMed

Insights

Sleep apnoea is common in patients undergoing coronary artery bypass grafting (CABG) and is linked to a higher risk of acute kidney injury (AKI). Treating sleep apnoea may help reduce the incidence of AKI after CABG.

Area of Science:

  • Cardiology
  • Nephrology
  • Sleep Medicine

Background:

  • Acute kidney injury (AKI) is a frequent complication following coronary artery bypass grafting (CABG).
  • Sleep apnoea is known to be associated with increased sympathetic activity, inflammation, and atherosclerosis.
  • The relationship between sleep apnoea and AKI post-CABG has not been previously investigated.

Purpose of the Study:

  • To determine if sleep apnoea is a risk factor for developing AKI after CABG.
  • To investigate the association between sleep apnoea, defined by Apnoea-Hypopnoea index (AHI), and AKI incidence.
  • To explore potential confounding factors influencing AKI risk in CABG patients with sleep apnoea.

Main Methods:

  • 169 patients scheduled for elective CABG underwent overnight sleep studies using a portable device.
  • AKI was defined as a serum creatinine increase >25% or >0.5 mg/dl within 5 days post-CABG.
  • A generalized structural equation model (gSEM) was employed to analyze the association between sleep apnoea (AHI ≥15) and AKI, adjusting for covariates.

Main Results:

  • The incidence of AKI among the 150 completers was 22.7%.
  • Patients with AKI had a significantly higher mean AHI (27.4 vs. 18.3) and a higher prevalence of sleep apnoea (64.7% vs. 45.7%) compared to the non-AKI group.
  • Sleep apnoea emerged as an independent predictor of AKI post-CABG (adjusted OR, 2.89; 95% CI, 1.09-7.09; P=0.03) after adjusting for haemoglobin, glucose, left atrial diameter, and systolic blood pressure.

Conclusions:

  • Sleep apnoea is a prevalent condition associated with an increased risk of AKI after CABG.
  • These findings suggest that sleep apnoea may be a modifiable risk factor for AKI in this patient population.
  • Further research into treating sleep apnoea could offer a novel strategy to mitigate AKI risk following cardiac surgery.
Abstract

Keywords:
ComplicationCoronary arteryRenal failureRisk factorSleep-disordered breathing

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